Comprehensive Comparison of Dysphagia Predominant Eosinophilic Esophagitis: With and Without Food Impaction

We describe 101 EoE patients with dysphagia, with food impaction (EoE-FI) and without food impaction (EoE-NoFI). Compare clinical features, endoscopy, histology and 10 additional histological features (AHF), and outcomes. Clinical features, dysphagia score, and endoscopic findings were captured. Eosinophils and 10 AHF at diagnosis and follow-up were done. Two hundred seven patients were seen with EoE, 101 patients with dysphagia enrolled; Follow period was; EoE-FI, and 71 EoE-NoFI and mean ages of 10.9 and 10.4 years, respectively (p = 0.27). Clinical features, EGD, and biopsies were almost similar in both groups. EoE-FI, 1.7 years (mean), range 1/12–8 years, and EoE-NoFI, 1.1 years (1/12–7 years). Dysphagia score improved from 3 to 1.25 in EoE-FI and 1.21 to 0.71 in EoE-NoFI (p < 0.001). Composite score improved from 3.3 to 1.45 and 2.49 to 1.48 (p < 0.001) in EoE-FI and EoE-NoFI; 15/30 (EoE-FI) and 45/71(EoE-NoFI) patients had repeat EGD. Peak eosinophils in EoE-FI improved from 60 to 27 (p = 0.03), and in EoE-NoFI from 47.6 to 33 (p = 0.001). Mean eosinophils in EoE-FI improved from 42 to 27.5 (p = 0.03), and EoE-NoFI from 39.3 to 22.1(p < 0.001). Comparison of the 10 AHF at diagnosis and follow-up showed minimal numerical (%) differences, and none were significant. During follow-up, none had recurrence or occurrence of FI in both groups. There were no significant differences in the clinical features and outcomes of dysphagia in EoE-FI and EoE-NoFI groups. Endoscopy including strictures and histologic findings of eosinophils and the 10 AHF were similar in both groups at diagnosis and follow-up.